Summary: Toddlers who excel at pretend play are significantly less likely to experience emotional and behavioral difficulties by the time they reach primary school. A major longitudinal study tracked over 1,400 Australian children to uncover this link.
The research suggests that imaginative play is not just recreational but a foundational developmental tool that supports long-term mental wellbeing, even when accounting for socioeconomic status, mother’s mental health, and language ability.
Key Facts
- Long-Term Prediction: Strong pretend play ability at ages two and three is associated with fewer mental health issues at ages four through seven.
- Challenging Assumptions: Surprisingly, “emotional regulation” (the ability to manage feelings) did not explain the link. This suggests play supports the brain through other mechanisms, such as embodied cognition.
- Brain-Body Connection: Researchers believe pretend play may engage motor brain regions that influence attention and anxiety, helping “wire” the brain for resilience early in life.
- Environmental Shift: The findings highlight a growing concern that screen time and highly structured schedules are “crowding out” the very type of free, imaginative play children need for healthy development.
Source: University of Sydney
Children who demonstrate pretend play ability as toddlers have significantly fewer emotional and behavioural difficulties at primary school, according to a new interdisciplinary University of Sydney study.
Published in Early Childhood Education Journal, the study found stronger pretend play ability among two and three-year olds was associated with fewer emotional and behavioural difficulties at later ages.
The findings held after accounting for participants’ family’s socioeconomic position, mother’s mental health, language ability and the security of their relationship with their parents.
Led by Dr Fontini Vasilopoulos from the Matilda Centre for Research in Mental Health and Substance Use and the CREATE CENTRE, the researchers analysed data from more than 1400 Australian children taking part in the Longitudinal Study of Australian Children.
Their pretend play ability was assessed by early childhood educators over a two-year period. Mental health outcomes were measured using parent and educator reports, submitted when participants were aged between four and five and again between the ages of six and seven.
Pretend play in early childhood linked to better mental health
In pretend play, children act out imaginary situations. Often viewed as purely recreational, the findings suggest it may play a more important role in children’s mental health development than previously recognised.
“We found that differences in pretend play ability very early in life were linked to differences in mental health outcomes several years later,” said Dr Vasilopoulos.
Mental health difficulties affect around one in seven Australian children, yet prevention efforts tend to focus on later childhood or adolescence. This study shifts attention to the earliest years of life, when foundational developmental skills emerge rapidly and before many children begin formal schooling.
Why early pretend play matters for families and schools
Unlike previous studies, the research was based on a large, population-based Australian sample, increasing its relevance for Australian families, educators and policymakers.
The findings come as opportunities for imaginative play are increasingly crowded out.
“These findings are especially relevant today, when many children spend more time on screens, take part in more structured activities, and have fewer opportunities for free, imaginative play,” said Dr Vasilopoulos.
“Pretend play can be easy to overlook, yet it plays an important role in supporting children’s mental health.”
Emotional regulation does not explain link
The researchers found emotional regulation did not explain the relationship between early pretend play ability and later mental health, challenging common assumptions about how play supports wellbeing.
“Emotional regulation – the ability to manage and respond to emotions – is often assumed to explain how early play influences later mental health, but that isn’t what we found,” said Dr Vasilopoulos. “When emotional regulation was taken into account, the association did not hold, suggesting other, less understood developmental processes may be involved.”
The researchers point to ‘embodied cognition’ as a possible explanation calling for further investigation. During pretend play, children possibly engage motor brain regions thought to play a role in attention and anxiety. This possible connection highlights how much remains unknown about how pretend play influences mental health.
Tips for encouraging child-led pretend play
The researchers emphasise the importance of child-led pretend play, and suggest adults can support it by:
- Letting play unfold for its own sake, rather than turning it into a teaching moment. If a child makes a mistake while counting or naming things during play, the priority is to keep the play going rather than interrupting to correct them.
- Following the child’s lead when joining in, much like a game of tennis. Waiting for the child to “serve” first helps keep play child‑led, though gentle prompts can help if a child is unsure how to begin.
- Responding to children’s play with simple observations or open‑ended comments instead of instructions. Describing what is happening in the play, or wondering aloud what might happen next, can enrich play without directing it.
- Stepping inside the play rather than directing it from the sidelines. Adults can ask children what role they would like them to take on, or suggest being a low‑power character, such as a confused visitor or a forgetful customer.
“Pretend play doesn’t need to be complicated or instructional,” said Dr Vasilopoulos. “Using this kind of gentle, child‑led involvement may be one practical way to build the pretend play abilities our research links to better mental health outcomes later in childhood.”
Key Questions Answered:
A: It is when a child acts out imaginary situations, using a block as a phone, “feeding” a stuffed animal, or pretending to be a doctor. The key is the child’s ability to assign new meanings to objects and roles.
A: Not necessarily. The study shows a correlation, not a guarantee. However, it suggests that pretend play is a skill that can be nurtured. If a child struggles with imagination, gentle, child-led play with an adult can help build those cognitive “muscles.”
A: No. The researchers emphasize that the play itself is more important than the “facts.” If a child says a blue block is a “red apple,” let it be. Interrupting to correct them turns a developmental play moment into a teaching moment, which can stop the flow of imaginative growth.
Editorial Notes:
- This article was edited by a Neuroscience News editor.
- Journal paper reviewed in full.
- Additional context added by our staff.
About this AI and auditory neuroscience research news
Author: Emily Fraser
Source: University of Sydney
Contact: Emily Fraser – University of Sydney
Image: The image is credited to Neuroscience News
Original Research: Open access.
“Longitudinal Evidence of the Relationship Between Pretend Play and Mental Health in the Early Years” by Fotini Vasilopoulos, Lucinda Grummitt, Sasha Bailey, Louise Birrell, Iroise Dumontheil, Gill Francis, Eliza Oliver, Olivia Karaolis, Robyn Ewing, Michael Anderson, Maree Teesson & Emma L. Barrett. Early Childhood Education Journal
DOI:10.1007/s10643-026-02150-7
Abstract
Longitudinal Evidence of the Relationship Between Pretend Play and Mental Health in the Early Years
Empirical evidence suggests that pretend play can help children manage anxiety. Few longitudinal studies have explored the benefits of pretend play on the mental health outcomes of children in the general population.
The current study explored longitudinal associations between pretend play at age 2–3 years old and mental health outcomes at age 4–5 and 6–7 using data from the Longitudinal Study of Australian Children, which included children born in 2004 (N = 1,426).
We also examined whether emotion regulation mediated this relationship. Children’s mental health was measured using the Strengths and Difficulties Questionnaire completed by primary caregivers and educators.
Higher pretend play ability at age 2–3 was associated with fewer internalising and externalising problems, even after controlling for attachment to main carer and other known predictors. Emotional regulation was not a significant mediator, suggesting that other unexplored factors may have mediated this relationship.
These findings suggest that pedagogical practices and high-quality preschool experiences that support the development of pretend play ability could contribute to reducing children’s mental health difficulties into primary school.
